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L. EMMETT HOLT. M. I). 



UBRARY OF CONGRESS 




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LIBRARY OF CONGRESS. 



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UNITED STATES OF AMERICA. 



THE CARE AND FEEDING 
OF CHILDREN 



A CATECHISM FOR THE USE OF MOTHERS 
AND CHILDREN'S NURSES 



^c^ 



BY. 



L EMMETT HOLT, M. D. 

PROFESSOR OF DISEASES OF CHILDREN IN THE NEW YORK POLYCLINIC 

ATTENDING PHYSICIAN TO THE BABIES' HOSPITAL AND THE 

NURSERY AND CHILD'S HOSPITAL, NEW YORK 




NEW YORK 

D. APPLETON AND COMPANY 

1894 






Copyright, 1894, 
By D. APPUETON AND COMPANY. 






TO 

Mrs. ROBERT W. CHAPIN, 

THROUGH WHOSE EFFORTS THE FIRST PRACTICAL TRAINING SCHOOL 

FOR children's NURSES IN AMERICA WAS ESTABLISHED, 

THIS BOOK IS RESPECTFULLY DEDICATED 

BY THE AUTHOR 



PEEFACE. 



Whe]^ in the fall of 1889 the Practical Train- 
ing School for IN'ursery Maids was opened in con- 
nection with the Babies' Hospital of IN'ew York, 
the need was soon felt for some simple manual to 
put into the hands of the nurses. None could be 
found which fulfilled the requirements of sim- 
plicitj", brevity, and exactness with reference to 
matters of infant feeding and nursery hygiene. 

A series of questions was written out by the 
author for the purpose of formulating for the 
nurses under training those things which were 
matters of daily observation in the practical 
work of the hospital. From time to time addi- 
tions have been made to these, until the present 
size has been reached. 

This catechism is now, at the request of many 
friends, published, with the hope that it may 

(5) 



PREFACE. 



serve a useful purpose in other institutions 
where similar schools for training may be estab- 
lished. At the same time, it is thought that it 
may be of value to many mothers in the care of 
their own children, or a book which they may 
safely put into the hands of the ordinary (un- 
trained) child's nurse. 

In the preparation of this catechism every- 
thing has been sacrificed to clearness and sim- 
plicity. It has been deemed best to emphasize 
strongly the essentials, without going into many 
minor details which would have increased mate- 
rially the size of the book without adding to its 
usefulness. The style of question and answer 
has been adopted in order to impress more 
strongly the facts stated. 



15 East Fifty-fourth Street, New York, 
March 6, 1894. 



CONTENTS. 



I. 

THE CARE OF CHILDREN. 

PAGE 

Bathing 9 

Eyes , . 9 

Mouth 10 

Skin 11 

Clothing 13 

Nursery 14 

Napkins . . . . . . . , . . .15 

Temperature of the Nursery 15 

Airing 16 

Weight 19 

Nursing 20 

Weaning 22 



II. 

INFANT FEEDING. 

Condensed Milk 28 

Mellin's Food 29 

Malted Milk . . . ' 30 

Imperial Granum 31 

Peptonized Milk . 32 

(7) 



8 THE CARE AND FEEDING OF CHILDREN. 

PAGE 

Sterilized Milk 38 

Bottles 34 

Intervals of Feediiii:^ 85 

Regularity in Feeding 36 

Feeding in the Second Year 39 

Feeding during the Third and Fourth Years . , . .42 

Articles forbidden 44 

Articles allowed » . . 45 

General Rules to be observed in Feeding 47 



III. 

MISCELLANEOUS. 

The Bowels . .49 

Sleep 50 

Cry 52 

Teething .55 

Walking alone 55 

Worms 56 

Temperature . . , .56 

Playing with Children 57 

Nursery Medicine . . 58 

Convulsions . . . .58 

Foreign bodies swallowed .58 

" " in the Ear 59 

" " in the Nose . . .... 59 

Colic. ' , , . .60 

Earache . . . , . .60 

Croup .... 61 

Contagious Diseases . • . 62 

Constipation 68 

Bad Habits 64 



THE CARE AND FEEDING 
OF CHILDEEN. 



I. 

THE CARE OF CHILDREN. 

BATHIT^G. 

At what age may a child he given a full tub 
hath? 

Usually when ten days old. 

How should the hath he gicen f 

It should not be given sooner than one hour 
after feeding. The room should be warm ; if 
possible, there should be an open fire. The bath 
should be given quickly, and the body dried rap- 
idly with a soft towel. 

At what temperature should a hath he given f 
For the first few weeks at 1 00° F. Later, dur- 
ing early infancy, at 95° F. After six months, 
at 90° F. 

EYES. 

How should the eyes of a little hahy he 
cleansed f 

With a piece of soft linen and lukewarm wa- 
ter to which a little salt has been added. 

(9) 



10 THE CARE AND FEEDING OP CHILDREN. 

If pus appears in the eyes, what should he 
done f 

They should be cleansed every two hours with 
a solution of boric acid (ten grains to one ounce 
of water). If the lids stick together, a little vase- 
line from a fresh bottle should be rubbed upon 
them at night. If the trouble is slight, this treat- 
ment will control it ; if it is severe, a physician 
should be called immediately, as delay may re- 
sult in loss of eyesight. 

MOUTH. 

How is an infanfs mouth to he cleansed f 
Always gently, lest the lining membrane 

should be injured ; plain lukewarm w^ater is 

generally sufficient. 

What is sprue f 

It appears on the lips and inside the cheeks 
like little white threads or flakes. It is also 
called thrush. In bad cases it may cover the 
tongue and the whole of the inside of the 
mouth. 

How should a mouth he cleansed when there 
is sprue f 

It should be washed carefully after every feed- 
ing or nursing with a solution of borax or bicar- 
bonate of soda (baking soda), and four times a 



SKIN. 11 

day the boric-acid solution mentioned should be 
used. 

SKIN. 

How should the infanfs sJcin he cared for 
to prevent chafing f 

First, not too much nor too strong soaps 
should be used ; secondly, careful rinsing of the 
body ; thirdly, not too vigorous rubbing either 
during or after the bath ; fourthly, the very free 
use of dusting powder in all the folds of the 
skin, under the arms, behind the ears, about 
the neck, in the groin, etc. This is of the ut- 
most importance in very fat infants. 

If the sMn is very sensitive and chafing 
easily produced^ what should he done? 

No soap should be used, but bran or salt 
baths given instead. 

How should a hran hath he prepared f 
One pint of wheat bran should be put in a 
bag of coarse muslin or cheese cloth, and this 
put in the bathing water. It should then be 
squeezed for five minutes, until the water re- 
sembles a thin porridge. 

How should a salt hath he prepared f 
A teacupful of common salt or sea salt 
should be used to each two gallons of water. 



12 THE CARE AND FEEDING OF CHILDREN. 

How should the hitttocJcs he cared for f 
This is the most common place for chafing, 
as the parts are so frequently wet and soiled ; 
hence the utmost pains should be taken that 
all napkins be removed as soon as they are 
wet or soiled, and the parts kept scrupulously 
clean. 

If the parts have become chafed what should 
he done f 

Only bran and salt baths should be used, and 
in very severe cases even these may have to be 
avjoided for a day or two. The parts may be 
cleaned with sweet oil and a little absorbent cot- 
ton, and the skin kept covered with a dusting 
powder composed of starch two parts, boric acid 
one part. 

What is priclcly heat, and how is it pro- 
duced f 

It consists of fine red pimples, and is caused 
by excessive perspiration and the irritation of 
flannel underclothing. 

How should it he treated f 

Muslin or linen should be put next to the 
skin ; the child should be sponged frequently 
with equal parts of vinegar and water, and 
plenty of the starch and boric- acid powder men- 
tioned should be used. 



CLOTHING. 13 



CLOTHIIS^G. 

What are the most essential things in the 
clothing of infants f 

That the chest shall be covered with soft flan- 
nel, the limbs well protected but not confined, 
and the abdomen supported by a broad flannel 
band, which should be pinned snugly but not too 
tightly. 

Of what use is the hand f 

It protects the abdomen, but its most impor- 
tant use is to support the abdominal walls in 
very young infants, and in this way to prevent 
the occurrence of rupture. 

How long is this hand required f 
A snug band not beyond four months. In 
healthy infants the flannel band may at this 
time be replaced by a knitted band. This may 
be worn np to eighteen months, although it is 
not essential after the first year. 

What changes are to he made in the clothing 
of infants in the summer f 

Only the thinnest ganze flannel undershirts, 
with short sleeves and low neck, should be worn, 
and changes in temperature should be met by 
changes in the outer garments. The greatest 
care should be given that children may not be 



14 THE CARE AND FEEDING OF CHILDREN. 

kept too hot in the middle of the day, while 
extra wraps are used morning and evening, 
especially at the seashore or in the moun- 
tains. 

Should older children he allowed to go with 
their legs dare f 

If strong and well there is no objection to 
this in very hot weather. In cold weather, how- 
ever, it is donbtf al if any children are benefited 
by it, particularly in a changeable climate like 
that of New York. Many delicate children are 
certainly injured by such attempts at harden- 
ing. 

What are the principoJ points to guard 
against in the clothing of older children f 

Not to put on too much thick clothing while 
in the house. Children are naturally warm- 
blooded, exercise a great deal, and very easily 
get too warm at their play. While in the street 
care should be taken to protect the legs and feet. 

NURSERY. 

What are the essentials in a good nursery f 
As large a room as possible should be se- 
lected — one that is well ventilated, and always 
one in which the sun shines at some part of the 
day. The nursery should have dark shades at 



NAPKINS. 15 



tlie windows, bat no extra hangings or curtains. 
About the baby's crib nothing but what can be 
washed should be allowed. 

NAPKINS. 

How should napMns he taken care off 
They should be immediately removed from 
the nursery when soiled or wet. ISTever should 
they be dried in the nursery. Soiled napkins 
should be kept in a receptacle with a tight cover, 
and washed as soon as possible. 

Should napTcins lohich Jtave been only wet he 
used a second time without washing f 

It is no doubt better to use only fresh nap- 
kins, but there is no serious objection to using 
them twice unless there is chafing of the skin. 

TEMPEEATUEE OF THE NIJESEEY. 

At what temperature should a nursery he 
kept during the day f 

Best about 68° F. Never should the ther- 
mometer be allowed to go above 70° F. 

At what temperature during the night f 
During the first two or three months not be- 
low ^^° F. After three months temperature may 
go as low as ^^° F. 



16 THE CARE AND FEEDING OF CHILDREN. 

At wliat age may the window he left open at 
night f 

Usually after the second month, excepting in 
severe weather. 

How often should the nursery he aired f 
At least twice a day — in the morning after 
the child's bath, and again in the evening before 
the child is put to bed for the night. This should 
be done thoroughly, and the child should be re- 
moved meanwhile to another apartment. 

What symptoms are seen in a child who is 
Icept in too hot a room f 

It becomes pale, loses appetite ; shows symp- 
toms of indigestion, occasionally vomits, stops 
gaining in weight, takes cold readily, and per- 
spires very much. Its condition may be such as 
to lead one to suspect very serious illness. 

AIEIN^G. 

At what age may a child go out of doors in 
the fall and spring f 

Usually at one month. In the summer it may 
go out when one week old. 

When in winter f 

Airing in the room may be begun when the 
child is one month old. At three months it may 
go out on pleasant days, being kept in the sun. 



AIRING. 17 

On what Mnd of days should a child not go 
out? 

In sharp winds, when the weather is extremely 
cold, and when the ground is covered with slush. 

What are the most important things to he at- 
tended to when the child is out in its carriage f 

To see that the wind never blows in its face, 
that the feet are properly covered and warm, and 
that the sun is never allowed to shine directly 
into the eyes when the child is either asleep or 
awake. 

Of what advantage to the child is the going 
out? 

Fresh air is required to renew and purify the 
blood, and this is just as necessary for health and 
growth as proper food. 

What are the effects produced in infants hy 
fresh air f 

The appetite is improved, the digestion is 
better, the cheeks become red, and all signs of 
health are seen. 

Is there any advantage in having a child taJce 
its airing during the first five or six months in 
the nurse'' s arms f 

None whatever. A child can be made much 
more comfortable in a baby carriage and can be 



18 THE CARE AND FEEDING OF CHILDREN. 

equally well protected against exposure by blank- 
ets and the carriage umbrella. 

Wliat are the objections to an infanVs sleep- 
ing out of doors f 

There are no real objections. It is not true 
that infants take cold more easily when asleep 
tban awake, while it is almost invariably the 
case that those who sleep out of doors are 
stronger children and less prone to take cold 
than others. 

What can he done for infants who talce cold 
upon the slightest provocation f 

They should be kept in cool rooms, and espe- 
cially when asleep. They should not wear too 
heavy clothing, so that they are in a perspira- 
tion a good deal of the time. Every morning 
the body, particularly the chest and spine, 
should be sponged with cold water (about 
60° Fahr.). 

Hoio should this cold hath he given f 
The child should stand in a tub containing 
a little warm water, and a large bath sponge filled 
with cold water should be squeezed two to three 
times over the body. This should be followed 
by a vigorous rubbing with a towel until the skin 
is quite red. In the case of infants a little higher 
temperature (65° to 70°) may be used. 



WEIGHT. 19 



WEIGHT. 

Should a Jiealthy cMld alioays gain in 
weight f 

During the first week there is usually a loss, 
but after this time a child that is perfectly 
healthy should gain steadily throughout the 
first year. 

At what time is the gain most rapid f 
During the first four months. 

How much should a healthy dahy weigh at 
the end of four and a half months f 
About twice as much as at birth. 

How much at the end of the first year f 
About three times as much as at birth. 

What is the average weeMy gain of a healthy 
hahy f 

From four to eight ounces during the first six 
months, and from two to four ounces during the 
second six months. 

Why is weighing necessary f 
Because nothing else tells so accurately how 
well the baby is thrivingo 



20 THE CARE AND FEEDING OF CHILDREN. 



NURSING. 

How often should cMldren he nursed during 
the first three days of life f 

Usually only four or five times daily, since 
there is only a very little milk secreted at tMs 
time. 

When does the milk come in abundance f 
Usually on the third day, sometimes not until 
the fourth or fifth day. 

Should the infant he fed anything during 
the first two days f 

Usually not ; if much food were necessary, 
we may be sure IN^ature would have provided it. 
Water may be given if the infant shows signs of 
thirst. 

How frequently should an infant he nursed 
during the first week f 

After the third day every two hours during 
the day, and twice during the night. 

How frequently during the later weeks of 
infancy f 

The intervals should be made exactly the 
same as those given elsewhere for artificial feeding. 

How long should the child he kept at the 
breasts for one nursing f 
Not over twenty minutes. 



NURSING. ' 21 



Should the child take both breasts at one 
nursing f 

If the milk is very abundant one breast may 
be sufficient, otherwise both breasts may be 
taken. 

What are the important things to he attended 
to in pursing f 

First, regularity ; it is just as important as in 
the case of bottle-feeding. Secondly, the nipples 
should be kept clean by being washed after every 
nursing. 

What should he the diet of a nursing mother f 

She should drink plenty of milk and gruel 

and eat an abundance of simple food, including 

meat, vegetables, fruits, but no tea or coffee, and 

ordinarily no wine or beer.'*' 

Are sour fruits likely to disturb a nursing 
infant f 

Never, unless they produce symptoms of in- 
digestion in the mother. 

What things in the mother are most likely to 
cause colic and indigestion in a nursing infant f 

Extreme nervousness, fright, fatigue, grief, 
or passion are the most common causes ; some- 
times menstruation. 



23 THE CARE AND FEEDING OF CHILDREN. 

What symptoms indicate that a nursing in- 
fant is well nourished f 

The child has a good color, sleeps two or three 
hours after nursing, or, if awake, is quiet, good- 
natured, and apparently comfortable. It gains 
steadily in weight. 

What are the symptoms which indicate that 
a child who is nursing is not nourished f 

It does not gain in weight, cries frequently, 
sleeps irregularly and always in short naps, suf- 
fers from colic, and the movements contain undi- 
gested food. Often it will nurse a long time at 
the breasts, sometimes three quarters of an hour 
before stopping. At other times, if the milk is 
very scanty, it may take the breast for a moment 
only, and then turn away in apparent disgust. 

Is there any objection to an infanVs being 
partly nursed and partly fed f 

None whatever ; it is often better to feed the 
baby during the night, in order not to disturb the 
sleep of the mother. 

WEANING. 

At what age should the child he weaned from 
the breast f 

Usually weaning should be begun at nine or 
ten months by substituting one feeding a day for 



WEANING. 23 



one nursing, later two feedings, and thus gradu- 
ally the child is to be taken from the breast alto- 
gether. 

At wJiat age should the weaning he com- 
pleted f 

Generally at one year. In summer it may 
sometimes be advisable to nurse an infant a little 
longer rather than wean it when the weather is 
very hot. 

How may some of the difficulties in weaning 
he oi^ercome f 

By feeding every nursing infant once a day 
from beginning. It then becomes accustomed to 
take its food from the bottle. This is a matter 
of great convenience during the whole period of 
nursing when the mother or nurse is from neces- 
sity away from the child for a few hours, and 
when more feeding is required at weaning time 
the child does not object. 



II. 
INFANT FEEDING. 

What is the best infanf s food f 
Mother's milk. 

What must every infant food contain f 
The same things which are in mother's 
milk. 

Of what is mothers milk composed f 
Thirteen parts solids and eighty-seven parts 
water. 

What are the solids f 

A fat, a carbohydrate, a proteid, and salts. 

What is the fat f 
The cream. 

What is the carbohydrate f 
The sugar of the milk. 

What is the proteid ? 
The curd of the milk. 

(34) 



INFANT FEEDING. 25 

What infant food comes nearest to motliefs 
milk f 

Cow's milk. 

How does it differ from motlief s milTc f 
It contains nearly three times as much curd 
and about half as much sugar. 

In feeding cow^s milk how is the proportion 
of curd lessened f 

By diluting the milk with two parts of water. 

What other changes are caused by this addi- 
tion of water f 

There is now too little cream and too little 
sugar. 

What is top milk f 

The upper portion, which may be taken off 
after the milk has stood six or eight hours. 

In what does it differ from ordinary milk f 
It contains about three times as much cream. 

If top milk is diluted with two parts of water ^ 
how much cream and curd will it contain f 
About the same as mother's milk. 

In what does it differ now from mothefs 
milk f 

It lacks sugar. 



26 THE CARE AND FEEDING OF CHFLDREN. 

What form of sugar may he added f 
Milk sugar is to be preferred, thougli cane 
sugar may be used. 

How mucTi sugar should he added to the di- 
luted milk f 

One heapiug teaspoonful of milk sugar to 
every four ounces of food ; or, if cane sugar, one 
teaspoonful to every six ounces of food. 

What else hesides plain water may he used 
to dilute millc f 
Barley water. 

How should this he made f 

Two tablespoonfuls of barley, and one quart 
of water ; boil steadily for six or eight hours, 
adding water as it boils away, then strain 
through a cloth and add a little salt ; or one 
teaspoonful of the prepared barley flour of the 
Health Food Co. (New York) or of Robinson's 
barley flour and one half pint of water ; add a 
little salt and cook twenty minutes. 

In what respect is this hetter than plain 
water f 

It prevents the curdling of the milk in large 
lumps in the stomach. 



INFANT FEEDING. 27 

How long will it Tceep f 

In winter two days. In summer it should be 
made fresh every day and kept on ice. 

How is top milJc ohtained f 

It is to be skimmed off carefully with a spoon 
from the top of a bottle or jar of milk after it has 
stood at least six hours. 

How mucli may he taken from a quart of 
milk f 

Usually six ounces ; if the milk is very rich, 
seven ounces ; if it is poor, not more than five 
ounces. 

Is titer e any other way of obtaining tJie 
proper proportions of fat and curd than hy 
taking the top milk f 

Yes ; instead of eight ounces of top milk, 
four ounces of ordinary cream and four ounces 
of plain milk may be used. 

What would he the proportions required in 
an infant two months old^ getting twenty-four 
ounces a day f 

Top milk 8 ounces, 

Barley water ... 16 '' 

Milk sugar 6 heaping teaspoonfuls, or 

Cane sugar 4 *' " 



28 THE CARE AND FEEDING OP CHILDREN. 

TJjp to wJiat age sliould these proportions he 
maintained f 

Usually until the child is seven or eight 
months old. 

What changes may then he made in the 
food? 

Twice as much milk may be taken from the 
top of the bottle, and this may then be diluted 
with an equal quantity of barley water. 

What would he the proper proportions for a 
child of eight months f 

Top milk 19 ounces, 

Barley water 19 ^' 

Milk sugar 9 teaspoonf uls, or 

Cane sugar 5 



u 



Is the milk from a single cow hetter for in- 
fant feeding than mixed milk from a herd f 

The mixed milk is usually to be preferred, 
since it will vary less from day to day than the 
milk of one cow. 

CONDENSED MILK. 

What is condensed milk f 
It is milk from which part of the water has 
been evaporated. 



INFANT FEEDING. 29 

What is the difference hetioeen the canned 
condensed milk and the fresh condensed milk f 

The canned condensed milk contains a large 
amount of cane sugar. 

How much should condensed milk he diluted 
for an infant one or two months old f 
Ten or twelve times. 

Is it a suitable food f 

No, as it contains too much sugar, and when 
diluted in this way has very little cream, so that 
it should never be used as a permanent food un- 
less cream is added to it. 

How much cream should he added ? 
About two thirds as much as the amount of 
the condensed milk before dilution. 



mellin's food. 

How strong should^ Meltings food he made 
for an infant f 

One teaspoonful to two ounces of water. 

Is this a suitable infant food f 
No, since it is almost all sugar, and contains 
no fat. 



30 THE CARE AND FEEDING OF CHILDREN. 

Should Mellin^s food he used witTi condensed 
milk f 

IN'ever, since they both have the same fault, 
that they are lacking in fat. 

MALTED MILK. 

What is malted milk f 

Very much the same as Mellin's food, except- 
ing that it contains a little fat. 

How strong should this he made f 
About one teaspoonful to two ounces. 

Should it he used for the only food for an 
infant f 

No, for the same reason as condensed milk 
and Mellin'^ food ; it lacks fat. 

What symptoms are seen in children fed 
upon foods lacking in fat f 

The teeth come late, the bones are soft, the 
muscles flabby. 

What symptoms are seen in children fed 
upon foods containing too much sugar f 

They are frequently very fat, but their flesh 
is very soft, they walk late, and they perspire 
readily about the head and neck. 



INFANT FEEDING. 31 

When are Melliri's food^ malted milk^ con- 
densed inilk^ etc. , to be used in infant feeding f 

Only as temporary substitutes for cow' s milk 
in cases of illness, or in cases of acute indigestion, 
but never as permanent foods. 

IMPERIAL GEANUM. 

How is imjperial granum prepared f 
Two teaspoonfuls of tlie flour and six ounces 
of water. Cook ten minutes, and then add an 
equal quantity of milk and cook for Ave minutes 
longer. 

Wlien may granum he gixen f 
After eight or nine months, and then not more 
than twice daily. 

Why is it not to he used for very young 
hahies f 

Because it consists of more than three fourths 
pure starch, and young babies can digest very 
little starch and very many of them none at all. 

What other foods are lilce imperial granum f 
Ridge's food, Robinson's patent barley, Hub- 
bell's prepared wheat ; these are prepared and 
used in much the same way as imperial granum. 



32 THE CARE AND FEEDING OF CHILDREN. 



PEPTONIZED MILK. 

What is peptonized milk f 

Milk which has been partly digested. 

What part of the milJc has been digested? 
The curd. 

What taste has peptonized milJc f 
Partly peptonized milk has no especial taste, 
but completely peptonized milk is quite bitter. 

How is milk peptonized f 

A peptonizing powder is added to plain or 
dilute top milk, which is kept at a temperature 
of 120° F. (or about as warm as the hand will 
bear easily) for from ten to twenty minutes if it 
is to be partly peptonized, for two hours if it is 
to be completely peptonized. 

In preparing partly peptonized milk should 
all the bottles for the day he peptonized at once 
or for each feeding separately f 

Either plan may be followed, but if all are 
prepared at once the milk should be scalded 
after peptonizing, or it will gradually become 
bitter. 

In lohatform is the peptonizing powder sold? 
Usually in tubes or as the peptogenic milk 
powder. 



INFANT FEEDING. 33 



STEEILIZED MILK. 

Why sJiould wiilk he sterilized f 

In order to kill the germs wMch are in it. 

What harm do the germs do f 

Some -of them cause the milk to turn sour, 
and others may be the cause of disease in chil- 
dren. 

SJiould milk always he sterilized when it is 
used for infant feeding f 

In the country, where fresh milk can be ob- 
tained directly from healthy cows, it is not ne- 
cessary. In cities, where the milk is not so fresh, 
it is always desirable, and in summer it should 
never be omitted. 

How is milk sterilized f 

By heating it up to a point sufficient to kill 
the germs. 

What is this point? 

About 170° F. is sufficient if kept up for thir- 
ty minutes. Milk heated up to this point is 
sometimes called Pasteurized milk, while by 
sterilized milk is meant that which has been 
heated to boiling point (212° F.). 
3 



34 THE CARE AND FEEDING OF CHILDREN. 

What are tJie relative advantages of steril- 
ized and Pasteurized milk f 

Pasteurized milk is very little or not at all 
altered in taste ; it is quite as easily digested as 
plain milk, but it will keep for two or three days 
only. Sterilized milk has the taste of boiled 
milk ; it is not quite so easily digested, but it 
will keep much longer. 

BOTTLES. 

How should bottles he cared for f 
As soon as they are emptied they should be 
rinsed with cold water and allowed to stand 
filled with borax water. Before the milk is put 
into them they should be thoroughly washed 
with a bottle brush and hot soapsuds and then 
placed for twenty minutes in boiling water. 

What sort of nipples should he used f 
Only simple straight nipples which, slip over 
the neck of the bottle. Those with a long tube 
are too complicated and too difficult to keep 
clean. Nipples made of black rubber are to be 
preferred. 

How should nipples he cared for f 

When not in use they should be kept in a 

solution of borax and carefully washed three or 

four times a day. 



INFANT FEEDING. 35 

How sJiould the food he jprejpared for a sin- 
gle day f 

The entire quantity should be made at one 
time. The sugar should be dissolved in the bar- 
ley water and mixed with the top milk in a 
pitcher and an equal quantity put into each one 
of the feeding bottles— seven bottles if the child 
is having seven meals a day, and ten bottles if 
the child has ten meals ; the bottles should then 
be stoppered tightly with absorbent cotton and 
placed on ice, or sterilized and then placed on 
ice. When the infant is to be fed, the milk 
should be warmed by placing the bottle in warm 
water and not poured from the bottle into a 
saucepan. 

INTEEYALS OF FEEDING. 

Hoio often should a hahy he fed during the 
first month f 

Every two hours during the day, twice dur- 
ing the night, or ten feedings during the twenty- 
four hours. 

At what age may the interval he made two 
and a half hours f 
At six weeks old. 

When may it he increased to three hours f 
Usually at three months. 



36 THE CARE AND FEEDING OP CHILDREN. 



Why should not a child he fed more fre- 
quently f 

It takes the stomach nearly two hours to di- 
gest a meal at two months, and about two and a 
half hours at five or six months, and if the meals 
are made too near together the second one is 
given before the first has been digested and vom- 
iting and indigestion result. The meals should 
be far enough apart to give the stomach a little 
time for rest just before each feeding. 



SCHEDULE FOR 


FEEDING AN AV 


ERAGE CHILD IN 


H HALTH. 


Age. 


No. of 
meals. 


Interval 

by day, 

between 

meals. 


Night 

feedings 

(10 p. M. 

to 6 A. M.). 


Quantity 

for each 

meal. 


Quantity for 

twenty-four 

hours. 


1 week . . . 

2 to 3 weeks 

4 weeks 


10 
10 
9 
8 
7 
6 
6 
5 
5 


2 hours 

2 " 

2 " 

f: 

3 " 
3 " 
3 " 
3 " 


2 
2 
1 
1 
1 


1 oz. 

2^ " 

3 " 

4 " 
5^ " 
6 •' 

n " 

8^" 


10 oz. 
15 " 
20 " 


6 " 


24 " 


3 months 

5 " 

6 " 

9 " 

12 " 


28 " 
33 " 
36 « 
37* " 
40 - 



REGULARITY IN FEEDING. 

How can a haby he taught to he regular in 
hahits of eating and sleeping f 

By always feeding at regular intervals and 
putting to sleep at exactly the same time every 
day and evening. 



INFANT FEEDING. 37 

When should regular training he begun f 
During the first week of life. 

Should a Tjoby he waJcened to he nursed or 
fed if sleeping quietly f 

Yes, for a few days. This will not be re- 
quired long, for regular feeding soon teaches an 
infant to awaken regularly for his meal almost 
upon the minute. 

Should regularity in feeding he Icept up at 
night as well as during the day f 

Only up to nine or ten o'clock ; after that 
time a baby should be made to sleep as long as 
possible. 

At what age may a well hahy go without 
food from 9 p. m. to 6 or 7 a. m, f 

Usually at four months, and always at five or 
six months. 

What are the principal causes of waJcef ni- 
nes s at night f 

Night feeding and overfeeding. 

What symptoms indicate that a hahy is get- 
ting too much food at once f 

Vomiting very soon after taking the bottle, 
and the appearance of undigested food in the 
stools. 



38 THE CARE AND FEEDING OF CHILDREN. 

What signs slioio tliat a haby is getting too 
little food? 

The bottle is emptied quickly and ravenous- 
ly, the child cries when it is taken away, sucks 
violently at his fingers, and cries before the next 
feeding is due. 

Why do infants vomit f 

Because too much food has been given, or be- 
cause there is indigestion. 

If a large part of the meal is vomited what 
should he done f 

Omit the next bottle altogether ; for the sec- 
ond bottle afterward, make the food much weaker 
and give only half the usual quantity. 

Hoio soon is anything besides the bottle or 
breast milk to be gioen to an infant f 

Usually at ten months you may begin with a 
little beef juice or a portion of a soft-boiled egg. 
If the bottle is given, arrowroot or farina may be 
added to one feeding each day. 

When should a child be weaned from the 
bottle f 

Always as early as eighteen or twenty 
months. It can easily be done at twelve or fif- 
teen months. 



INFANT FEEDING. 39 



FEEDING IN THE SECOND YEAK. 

How many meals a day does a Jiealthy cJiild 
require during tJie second year f 

Never more than five, and some do better 
with four meals during tlie latter half of the 
year. 

Wliat are the best hours if five meals are 
given f 

Seven a. m. and 10 a. m., and 1 p. m., 4 p. m., 
and 7 p. M., with nothing whatever during the 
night; sometimes 7 a. m., 11 A. m., 2 p. m., 6 p. m., 
and 10 p. M. will suit the child better ; but which- 
ever schedule is adopted, the hours should al- 
ways be regular. 

Should all these meals he of the same size f 
It is better to make the 10 a. m. and 4 p. m. 
meals rather smaller than the others. 

Give a. sample diet for a child eighteen 
months old. 

First meal : A tablespoonful of some cereal 
with salt and one tablespoonful of cream, one 
half pint of milk. 

Second meal : One half pint of milk. 

Third meal : One tablespoonful of scraped 
meat, two small pieces of dried bread, half a pint 
of milk. 



40 THE CARE AND FEEDING OF CHILDREN. 

Fourth meal : Milk. 

Fifth meal : Milk with farina or arrowroot. 

Which of the cereals are most useful for 
children f 

Oatmeal, barley, wheat, rice, hominy. 

How should these he prepared f 

Hominy, rice, and the others, if the grains 
are used, should be soaked for from four to six 
hours and then cooked steadily for three hours 
in a double boiler, and for all infants under two 
years old they should be strained. 

If the prepared (steamed) oats or wheat are 
used, they should be cooked at least one hour 
and strained. 

How is the meat to he prepared f 

It should be broiled and then scraped to a 
pulp. Only roast beef, steak, and mutton chops 
should be used. 

May anything else talce the place of meat at 
the midday meal f 

Yes, either beef juice or iigg may be substi- 
tuted. 

How is heef juice made f 
A piece of round beefsteak should be broiled 
for a few minutes and then squeezed in a meat 



INFANT FEEDING. 41 

press or lemon squeezer, and the juice salted and 
given warm. 

How much should he given to a child eight- 
een months old f 

From one to three tablespoonf uls at a time. 

In what form should eggs he given f 

They should be either soft boiled or poached 

— never fried. They should not be given every 

day, as children easily tire of them. 

Can a child at one year old taJce plain milk f 
Many children can, bnt the majority do bet- 
ter when the milk is modified by the addition 
of cream and water, or by the use of diluted top 
milk. 

How should the top milk he prepared for a 
child of one year f 

After standing six hours, six onnces should 
be taken off with a spoon from the top of a 
milk bottle, and ten ounces more should then be 
poured off and the two mixed. This may be di- 
luted with an equal quantity of water or barley 
water. 

How much milk at once should he allowed 
at a single feeding for a child during the sec- 
ond year f 

From eight to ten ounces during the first half, 



42 THE CARE AND FEEDING OF CHILDREN. 

and from ten to twelve ounces during tlie latter 
half of the year. 

FEEDING DURING THE THIRD AND FOURTH 

YEARS. 

How many meals sltould he given f 
Four in most cases. 

SJiould cMldren 'be fed between meals f 
Under no circumstances should anything but 
water be given between the regular meals. 

What are the best hours lohen four meals 
are given f 

Usually 7 a. m. and 10.30 a. m. ; 1.30 p. m. 
and 6 p. m. 

Give a sample diet for a child four years 
old. 

First Meal. — Half an orange, one and a half 
tablespoonsful of oatmeal or hominy, well salted, 
with two tablespoonfuls of cream, but no sugar, 
and one glass of milk. 

Second Meal. — A glass of milk or cup of broth 
with one slice of stale bread. 

Third Meal. — Meat — either steak, chop, or 
chicken — one green vegetable (e. g., spinach), one 
starchy vegetable (e. g., potatoes), water to 
drink, stewed prunes for dessert. 



INFANT FEEDING. 43 

Fourth Meal. — Bread and milk or milk toast. 

In wliatform sJiould bread he given to young 
children f 

Always stale and preferably dried until it is 
quite crisp. Butter may be given after the third 
year. 

What fruits may he given to young children f 
First, orange juice, prune pulp and baked 

apple. These may be allowed after the fifteenth 

month. 

How much should he given and how should 
they he prepared f 

The juice of one fourth or one half an orange 
or the pulp of three or four stewed prunes which 
have been put through a sieve to remove the 
skins, or half of a baked apple without sugar. 

What fruits may he given to a child of three 
or four years f 

Nearly all the fresh fruits in season, except 
bananas. 

Are fruits an important part of a chiWs 
diet f 

Yes ; they help the digestion of other food 
and keep the bowels regular. 



44 THE CARE AND FEEDING OF CHILDREN. 
ARTICLES FORBIDDEN. 

The following articles of food are improper 
for a healthy child under four years of age in 
all circumstances. Nearly all of them should be 
prohibited in the case of children under seven 
years : 

Meats. — Ham, sausage, pork in all forms, 
salt fish, corned beef, dried beef, goose, duck, 
game, kidney, liver and bacon, meat stews, and 
dressings from roasted meats. 

Vegetables. — Potatoes except when roasted, 
cabbage, raw or fried onions, raw celery, rad- 
ishes, cucumbers, tomatoes (raw or cooked), beets, 
egg-plant, and green corn. 

Bread and ealce. — All hot bread, biscuits, or 
rolls ; buckwheat and all other griddle cakes ; 
all sweet cakes, particularly those containing 
dried fruits and those heavily frosted. 

Desserts. — All nuts, candies, dried fruits ; all 
canned or preserved fruits ; pies, tarts and pas- 
try of every description. 

Dririks. — Tea, coffee, cocoa, wine, beer and 
cider. 

Fruits. — Bananas ; all fruits out of season ; 
all stale fruits, particularly in cities and during 



INFANT FEEDING. 45 

the summer. Grapes are objectionable only on 
account of the seeds. With most of the other 
fruits it is excess in the quantity which makes 
them injurious. 

ARTICLES ALLOWED. 

The following list of articles of food may be 
given to healthy children from eighteen months 
to four years of age. From these a daily diet 
list may be made up in the manner indicated on 
page 42. 

Milk. — Always the basis of the diet, one 
quart daily ; without dilution unless very rich ; 
always warm. 

^^p'^. — Soft-boiled or poached, never fried, 
not oftener than three times a week. 

Meats, — After eighteen months if most of 
the teeth are present, once daily ; finely bruised 
or scraped ; rare roast beef, roast lamb, broiled 
mutton chop or beefsteak, white meat of chicken 
or turkey ; fresh fish, boiled or broiled, bones 
the only objection. 

Vegetables. — Potatoes (not till two years) 
roasted, peas, asparagus tops, spinach, string 
beans, boiled onions, stewed celery ; all should 
be very well cooked, in season, and fresh. 



46 THE CARE AND FEEDING OF CHILDREN. 

Cereals. — Oatmeal, wheaten grits, hominy, 
barley, rice, farina, and arrowroot ; all should 
be cooked at least two hours, and given with 
milk or cream, well salted, without any sugar. 

Broths, etc. — Beef juice expressed from 
broiled round steak (one half to one pound) ; 
mutton, or beef, or chicken broth, as follows : 
one pound of finely chopped lean meat, one pint 
of water, stand on ice four to eight hours, cook 
slowly one hour, strain and season with salt, cool, 
and skim off fat. 

Bread and Crackers. — In some form to be 
given with each meal ; only stale bread (well 
baked), toast, zwieback ; Grraham, oatmeal, and 
gluten crackers, with meals only. 

Desserts. — (After two and a half years) plain 
custard, ice cream (not of tener than once a week), 
rice pudding (no raisins), baked apple, stewed 
prunes. 

Fruits. — (After fifteen months) oranges ; 
(after two and a half years) apples, pears, grapes, 
berries, etc. In the country, almost all varieties 
in moderate quantity ; give very cautiously in 
cities and during the summer. 



INFANT FEEDING. 47 

GENERAL EULES TO BE OBSERVED IN 
FEEDING. 

Whether the child feeds himself or is fed 
by the nurse, the following rules must be ob- 
served : 

1. Plenty of time must be taken. On no 
account should the child bolt his food. 

2. The child must be taught to chew his 
food. 

3. Children should not be continually urged 
to eat if they are disinclined to do so at their reg- 
ular hours of feeding, or if the appetite is habit- 
ually poor, and under no circumstance should a 
child be forced to eat. 

4. Indigestible food should never be given 
to tempt the appetite when the ordinary sim- 
ple food is refused ; food should not be al- 
lowed between meals when it is declined at 
meal-time. 

5. If a child refuses its food altogether, or 
takes less than usual, the food must be examined 
to see if this is right. Then the mouth must be 
inspected to see if it is sore. If neither of these 
things is the cause, the food should be taken 
away and not offered again until the next feed- 
ing time comes. 

6. In any acute illness the amount of food 
should be much reduced and the food made more 



48 THE CARE AND FEEDING OF CHILDREN. 

dilute than usual. If there is fever, no solid food 
sliould be given. Milk should be peptonized if 
there is difficulty in digestion. 

7. In very hot weather the same rules hold — 
give less food, particularly less solid food, and 
more water. 



III. 
MISCELLANEOUS. 

THE BOWELS. 

How many movements daily should an in- 
fant have during the first few weeJcs of life f 

Usually three or four a day for the first week, 
and then two or three each day. 

How many after a child' is a month old f 
Usually two each day, but often only one. 

What is the appearance of a healthy move- 
ment from a child who has taken nothing dut 
milk f 

It is soft, yellow, and smooth, containing no 
lumps. 

When are the stools dark hrown or Mack f 
While taking bismuth, iron, and sometimes 
when taking much meat or beef juice. They 
may be dark brown or black from blood. This 
last is a condition which may indicate serious 
illness. 

4 (49) 



50 THE CARE AND FEEDING OF CHILDREN. 

How may a cliild he trained to be regular in 
its bowels f 

By endeavoring to have them move at exactly 
the same time every day. 

At what age may an infant he trained to use 
the chamher or chair for its movements f 

Easily by the third month if training is begun 
early. 

SLEEP. 

Should a child sleep in the same hed with its 
mother or nurse f 

Under no circumstances if this can possibly 
be avoided ; nor should older children sleep to- 
gether. 

How should an infanVs hed he prepared? 

The mattress should be firm but soft, the pil- 
low very thin, and the covering should not be 
excessive. A child should not be allowed to 
sleep always in the same position, but should be 
changed from side to side. Hair pillows are 
useful in summer and for children who perspire 
very much. 

How much sleep is natural for a newly horn 
hahy. 

Most infants will sleep at this period about 
nine tenths of the time. 



SLEEP. 51 

How much should a child sleep at one year f 
About two thirds of the time. 

Up to what age should an older child take a 
nap during the day f 

Always until four years old, and if possible 
longer. 

At what age may an infant go all night with- 
out feeding f 

At five months a child should not be fed or 
nursed between 10 p. m. and 7 a. m. At one 
year a child w^ill usually go from 7 p. m. to 7 
A. M. without feeding or nursing. 

How should a child he put to sleep f 
The room should be darkened and quiet, the 
child's hunger satisfied, and the child made gen- 
erally comfortable and laid in its crib while 
awake. 

Is rocking necessary f 

By no means. It is a habit easily acquired, 
but hard to break, and a very useless and some- 
times injurious one. 

What are the principal causes of sleepless- 
ness f 

The most frequent one is indigestion from 
overfeeding ; often it is feeding too frequently at 



53 THE CARE AND FEEDING OP CHILDREN. 



night. A child who is fed three or four times at 
night is invariably a bad sleeper. 



What are some other causes of waJcefulness f 
In nervous children it may come from excite- 
ment, like romping and playing just before bed- 
time. Bad sleep is also one of the earliest and 
most frequent signs of illness. In older children 
sleep may be disturbed by fear excited by the 
stories told just before bedtime. 

When are children likely to sleep too much f 
Too much sleep is rare, excepting from serious 
illness, or from the use of soothing sirups or 
other drugs. These should never, under any 
circumstances, be given. 

CRY. 

When is crying useful f 

In the nev\^ly born infant the cry expands the 
lungs, and it is necessary that it should be re- 
peated for a few minutes every day in order to 
keep them well expanded. 

How much crying is normal for a very young 
hahy f 

From fifteen to thirty minutes a day. 



THE CRY. 53 



WJiat is the nature of this cry f 

It is loud and strong. Infants get red in 
the face with it ; in fact, it is a scream. This 
is necessary for health. It is the baby's exer- 
cise. 

When is a cry abnormal f 

When it is too long or too frequent. The 
abnormal cry is rarely strong, but it is a moan- 
ing or a worrying cry, sometimes only a feeble 
whine. 

What are the causes of such crying f 
Pain, temper, hunger, illness, or from habit. 

What is the cry of pain f 

It is usually strong and sharp, but not gener- 
ally continuous. It is accompanied by contrac- 
tion of the features, drawing up of the legs, 
and other symptoms of distress. 

What is the cry of hunger f 
It is usually a continuous, fretful cry, rarely 
strong and lusty. 

What is the cry of temper f 

It is loud and strong and accompanied by 
kicking or stiffening of the body, and is usually 
violent. 



54 THE CARE AND FEEDING OF CHILDREN. 

What is the cry of illness f 

This is usually more of a fretfulness and wor- 
rying than a real cry, although crying is ex- 
cited by very slight causes. 

Wliat is the cry of indulgence or from habit f 
This is often heard even in very young in- 
fants, who cry to be rocked, to be carried about, 
sometimes for a light in the room, for a bottle to 
suck, or for the continuance of any other bad 
habit which has been acquired. 

How can we he sure that a child is crying to 
he indulged f 

If it stops immediately when it gets what 
it wants, and cries when it is withdrawn or with- 
held. 

How is an infant to he managed that cries 
from temper or to he indulged f 

It should simply be allowed to cry it out. A 
second struggle is rarely necessary. 

Is it nicely that rupture will he caused from 
crying f 

Not in young infants if the abdominal band 
is properly applied, and not after a year under 
any circumstances. 



TEETHING. 55 



TEETHIN^G. 

When do the first teeth appear f 

Usually from the fifth to the eighth month. 

What symptoms are commonly seen in teeth- 
ing f 

There is very often great fretfulness and poor 
sleep for two or three nights ; there may be loss 
of appetite, so that only one half the nsual 
amount of food is taken, and there is salivation 
or drooling, and often a slight fever. There may 
be some symptoms of indigestion, such as vomit- 
ing or the appearance of undigested food in the 
stools. 

How long do these symptoms last f 
Usually only two or three days. 

What is the cause of most of the other symp- 
toms attributed to teething f 

Nearly all of them come from indigestion due 
to bad feeding. 



At what age does a child usually sit alone f 
At seven or eight months. 

When should a child loalk alone f 
From thirteen to fifteen months. 



56 THE CARE AND FEEDING OF CHILDREN. 

Should cMldren he urged to walk f 
iN'o, for they are always ready to do so as 
soon as their muscles are strong enough. 



How should a child he lifted f 
Always by placing the hands under the child's 
arms, and never by grasping the wrists. 

What injury may he inflicted hy lifting the 
child hy the wrists or hands f 

Often serious injury is done to the elbow 
joint, or even to the shoulder. 



Are worms common in infants f 

They are extremely rare in children under 
two years old, and even in those over two years 
they are not at all common. 

. What is the explanation of most of the symp- 
toms supposed to he due to worms f 

They are nearly all from indigestion, the re- 
sult of bad feeding. 



What is the normal temperature of an infant f 
Mnety-eight and a half degrees to 99° F. in 
the rectum. 



TEMPERATURE. 57 



How mucJi does it vary in liealth f 
Between 98° and 99-5° F. 

How long should the thermometer he left in 
the rectum to take the temperature f 
Three minutes. 

Is the temperature of an infant a good sign 
as to the severity of its symptoms in illness f 

As a rule it is. A temperature of 100° to 102° 
F. commonly means a mild illness. From 102° 
to 104° F. a more serious one. 



At what age may playing with hahies he 
begun f 

JN'ever until four months, and better not until 
six months. The less of it at any time the better 
for the infant. 

What harm is done hy playing with very 
young hahies? 

They are made nervous and irritable, sleep 
badly, and sv.ffer in other respects. 

When should children he played with f 
If at all, in the morning, or after the midday 
nap. Never just before bedtime. 



58 THE CARE AND FEEDING OP CHILDREN. 



NURSERY MEDICINE. 

Tf'hat should he done for a child in convul- 
sions hefore a doctor arrii^es f 

Keep the child perfectly quiet, with ice at the 
head, put the feet in a mustard bath, and roll 
the entire body in large towels which have been 
dipped in mustard water. 

How should the mustard water he made f 
Two heaping tablespoonfuls of mustard to 
one quart of tepid water. 



What should he done for a child with hleed- 
ing from the nose f 

The child should sit upright, the nose should 
be comj)ressed tightly with the fingers, and iced 
cloths applied to the nose. The child should not 
blow his nose for some time afterward. 



What should he done if a foreign hody has 
heen swallowed f 

First, examine the throat with the finger to 
see if it has lodged there, and if so, remove it. 
If it has passed from the throat it has usually 
gone into the stomach. 



FOREIGN BODIES SWALLOWED. 59 

What should he done in this ease f 
Give the child plenty of dry food, like bread, 
potato, etc., but under no circumstances Qither 
an emetic or cathartic. An infant may have its 
nsual food. 

What harm loould a cathartic do f 
It is likely to hurry the foreign body too rap- 
idly through the bowels, and in this way do harm ; 
otherwise it becomes coated with fsecal matter 
and passes the intestine nsually withont doing 
injury. 



What should he done if a child gets a for- 
eign hody into the ear f 

Unless this can easily be removed with the 
fingers it should not be meddled with, for it is 
likely to be pushed farther into the ear. The 
child should be taken to a physician. 



What should he done if there is a foreign 
hody in the nose f 

The child should blow his nose strongly 
while the empty nostril is compressed. Unless 
this removes it a physician should be called. 
Meddlesome interference is always harmful. 



60 THE CAEE AND FEEDING OF CHILDREN. 

What are the symptoms of colic f 
There is a strong, hard cry, which comes sud- 
denly and returns every few minutes. With this 
there is drawing up of the feet, contraction of 
the muscles of the face, and other signs of pain. 
The abdomen is usually tense and hard. 

What should he done for a case of colic f 
First, see that the feet are warm. Place them 
against a hot-water bag, or hold them before an 
open fire ; apply a hot flannel to the abdomen, 
or let the child lie upon its stomach across a hot- 
water bag. If the colic continues, a half teacup- 
ful of warm water containing ten drops of tur- 
pentine may be injected into the bowels with a 
syringe ; at the same time the abdomen should 
be gently rubbed so as to start the wind. If the 
gas is in the stomach, a teaspoonful of Yichy 
with five drops of gin or brandy may expel it. 



What are the symptoms of ear-ache f 
The pain is generally severe and accompanied 
by a sharp scream ; the child puts the hand to the 
affected ear, or cries whenever it is touched. The 
pain is likely to be prolonged and continuous. 

How should a child with ear-ache he treated f 
Twenty drops of warm water should be put 



CROUP. 61 



into the ear, and a poultice of flaxseed applied 
warm, but not too hot, or the hot-water bag may 
be held against the ear. 



What are the symptoms of croup f 
There is a hollow, dry, barking cough, with 
some difficulty in breathing. 

When is this likely to come on f 
Usually at night. 

Is simple croup dangerous f 

The ordinary croup of infants is spasmodic 
croup, and is very rarely dangerous, although the 
symptoms seem very alarming. 

What is the dangerous form of croup f 
Membranous croup. 

How does this develop f 

Gradually ; very rarely does it come on sud- 
denly. 

What should be done for a baby who has 
spasmodic croup f 

The room should be very warm, hot cloths or 
poultices should be applied over the throat, and 
either a croup kettle or an ordinary tea kettle 
kept boiling in the room. If the symptoms are 



62 THE CARE AND FEEDING OF CHILDREN. 



urgent, ten drops of the sirup of ipecac should 
be given every fifteen minutes until free vomit- 
ing occurs. 

CONTAGIOUS DISEASES. 

How does measles begin f 

Gradually, like an ordinary cold in the head, 
with cough, sneezing, running eyes and nose. 
The eruption usually appears on the fourth day, 
first on the face and neck. 

How does scarlet fever begin f 

Generally it comes suddenly, with vomiting, 
high fever, and sore throat. The eruption ap- 
pears upon the second day, first upon the neck 
and chest. 

How does diplitJieria begin ? 

Sometimes suddenly, but usually very grad- 
ually, with sore throat and often swelling of the 
glands of the neck, with w^hite patches upon the 
tonsils, or a very free discharge from the nos- 
trils. 

At what period are these diseases contagious f 

From the very beginning of the symptoms. 

Measles and scarlet fever are quite as likely to 

be communicated in the early stages as when the 

eruption is fully out. 



CONSTIPATION. 63 



How long should a child with any of these 
diseases he Icept away from other children f 

In measles, two weeks after the rash has 
gone ; in scarlet fever, at least four weeks after 
the rash has gone, and longer if the peeling is not 
over or if the ears are running ; in diphtheria, at 
least three weeks after the throat is well, and 
four weeks if the case has been severe. 

What should he done if a child shows the 
first symptoms of serious illness f 

The child should be put to bed. If it is an 
infant, the food should be diluted to one half the 
usual strength. If an older child, only fluid food 
should be given. If the child seems feverish 
take the temperature. If the bowels are consti- 
pated give a teaspoonful of castor oil, but no 
other medicine without the doctor's orders. Send 
for the doctor at once, and until he comes care- 
fully exclude all other children from the room. 

CONSTIPATION. 

In children who are upon milk diet what is 
the principal cause of constipation f 

The milk has too much curd and too little fat. 



How is this difficulty overcome f 
By adding water and cream. 



64 THE CARE AND FEEDING OF CHILDREN. 

Wlien it is necessary to move the towels im- 
mediately^ wliat is tlie easiest method f 

An injection of one tablespoonful of sweet oil 
may be given, or half a teaspoonful of glycerin 
in two teaspoonfuls of water, or a glycerin sup- 
pository. These should not be continued ex- 
cepting under the physician' s directions. 

What is the most essential thing in prevent- 
ing or overcoming constipation f 

The formation of the habit of having the bow- 
els move every day regularly at the same hour. 

What is tlie hest hour f 

In most cases immediately after the first meal 
in the morning. 

How is constipation to he treated ? 

The most important thing is the regulation of 
the diet, the giving of fruits, especially orange 
juice and stewed prunes. 

When should these he given f 
To very young children best about one hour 
before meals. 

BAD HABITS. 

What are the most common had hahits of chil- 
dren f 

Sucking, nail-biting, bed- wetting, and mas- 
turbation. 



BAD HABITS. 65 



What do children suck f 

Most frequently the thumbs, sometimes the 
fingers, the hand, the clothing, or the blanket, 
often a rubber nipple or a sugar rag. 

When is this habit usually seen f 

It begins in quite early infancy, and if not 

broken up may last until children are six or 

seven years old. 

At what age is tlie nail-biting seen f 
Usually in children from two to five years old. 

At what age may an infant generally be ex- 
pected to go without loetting during the night f 

Usually at two and a half years if it is taken 
up late in the evening. 

What is masturbation f 

It is the habit of rubbing the genital organs 
with the hands, with the clothing, against the 
bed, or rubbing the thighs together. It may be 
seen in children as young as a year old. 

What should be done when one of these hab- 
its is discovered f 

The fact should be brought immediately to 

the notice of the mother and physician, and 

every means taken to break up the habit while 

the child is young and before it becomes deeply 

seated. 

5 



66 THE CARE AND FEEDING OF CHILDREN. 

In the case of sucking or nail-biting confining 
the hands to the sides during sleep or the wear- 
ing of mittens will often succeed if persisted in. 
On no account should the habit of sucking be 
allowed as a means of putting children to sleep 
or of quieting them while restless or suffering 
from indigestion. 

Bed-wetting is more of a disease than a habit, 
and the child should never be whipped for it ; it 
should receive medical treatment. 

Masturbation is the most injurious of all these 
habits, and should be broken up just as early as 
possible. Children should especially be watched 
at the time of going to sleep and on first waking. 
Punishments are of little avail and usually make 
matters worse. Medical advice should at once 
be sought. 



THE END. 



D. APPLETON & CO.'S PUBLICATIONS. 

/I TEXT-BOOK OF NURSING, for the use of 

•^~L Training- Schools, Families^ and Private Students. Compiled 
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/J MANUAL OF INSTRUCTION IN THE 

-^ PRLNCLPLES OF PROMPT ALD TO THE LNfURED. 

Designed for Military and Civil Use. By Alvah H. Doty, 

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D. APPLETON & CO.'S PUBLICATIONS. 



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TyTZOMEN, PLUMBERS, AND DOCTORS; 

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Contents, — Hygienic Houses. — Under the House, — Arrangement of the House. — 
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Germs. — Overlooked Channels of Infection. — Our Neighbor's Premises. — Public Sani- 
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'BE CHEMISTRY OF COMMON LIFE. By 

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Summary of Contents. — The Air we Breathe. — The Water we Drink. — The Soil 
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we Dislike. — The Colors we Admire. — What we Breathe and Breathe for. — What, 
How, and Why we Digest. — The Body we Cherish. — The Circulation of Matter. 



o 



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F. R. S., Fellow of the Royal College of Physicians of London, 

etc i2mo Cloth, $1.75. 

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r 




'HE POISON PROBLEM; or, The Cause and Cure 
of INTEMPERANCE. By Felix L. Oswald, M. D., au- 
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i2mo. Cloth, 75 cents ; paper, 25 cents. 

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most destructive and pernicious of poisons at that. Temperance reformers and workers 
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ance." — Boston Traveller. 

TTEALTH PRIMERS. Edited by J. Langdon 
J^ Down, M D., F. R. C. P. ; Henry Power, M. B., F. R. C. S. ; 

J. Mortimer Granville, M. D. ; John Tweedy, F. R. C. S. 
In square i6mo volumes. Cloth, 40 cents each. 

I. Exercise and Training. — TI. Alcohol: Its Use and Abuse. — III. Premature 
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T 



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Contents : The Golden Rug- of Kermanshah ; Warders of the Woods ; 
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OCIAL ETIQUETTE OF NEW YORK. Re- 
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s 



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'' r^OOD FORM'' IN ENGIAND. By An 
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I NTS ABOUT MEN'S DRESS: Right Prin- 
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APPLETONS' HOME BOOKS. Complete in 12 volumes, 12mo. 
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The twelve books are also put up in three volumes, four books to the volume, 
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I. 
BUILDING A HOME. By A. F. Oakey. Illustrated. 

II. 
HOW TO FURNISH A HOME. By Ella Rodman Chukoh, Illustrated 

III. 
THE HOME GARDEN. By Ella Rodman Church. Illustrated. 

IV. 
HOME GROUNDS. By A. F. Oakey. Illustrated. 

V. 

HOME DECORATION. Instructions m and Designs for Embroidery, Panel 
and Decorative Paintings, WoorJ-carvinir, etc. By Janet E. Ruutz-Rees, 
author ot "Horace Verhet." Illustrated. 

VI. 
THE HOME NEEDLE. By Ella Rodman Church. Illustrated. 

VII. 
AMENITIES OF HOME. By M. E. W. S. 

VI n. 

HOUSEHOLD HINTS. A Book of Home Receipts and Home Suggestions- 
By Mrs. Emma W. Babcock. 

IX. 

THE HOME LIBRARY. By Arthur Penn, editor of "The Rhymester.' 
Illustrated. 

X. 

HOME OCCUPATIONS. By Janet B. Ruutz-Rees. Illustrated. 

XL 

HOME AMUSEMENTS. By M. E. W. S.. author of "Amenities of Home," 
etc. 

XII. 

HEALTH AT HOME. By A. H. Guernsey, and I. P. Davis, M. D., au- 
thor of "• Hygiene for Girls." 

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airreement of English readers, but most of them, like the present volume, emanat- 
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of householders, and therefore likely to guide them aright where their ov/n taste 
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New York: D. APPLETON & CO., 1, 3, & 5 Bond Street. 



